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Optimal metrics for identifying long term patterns of depression in older HIV-infected and HIV-uninfected men who have sex with men

TitleOptimal metrics for identifying long term patterns of depression in older HIV-infected and HIV-uninfected men who have sex with men
Publication TypeJournal Article
Year of Publication2018
AuthorsArmstrong, NM, Surkan, PJ, Treisman, GJ, Sacktor, NC, Irwin, MR, Teplin, LA, Stall, RC, Jacobson, LP, Abraham, AG
JournalAging Ment Health
Pagination1-8
Date PublishedFeb 9
ISBN Number1360-7863
Accession Number29424569
Keywordsdepression, HIV infection, sensitivity, specificity, Validity
Abstract

OBJECTIVES: Center of Epidemiologic Studies-Depression Scale (CES-D) provides a snapshot of symptom severity at a single point in time. However, the best way of using CES-D to classify long-term depression is unclear. METHOD: To identify long-term depression among HIV-infected and HIV-uninfected 50+ year-old men who have sex with men (MSM) with at least 5 years of follow-up, we compared sensitivities and specificities of CES-D-based metrics (baseline CES-D; four consecutive CES-Ds; group-based trajectory models) thresholded at 16 and 20 to a clinician's evaluation of depression phenotype based on all available data including CES-D history, depression treatment history, drug use history, HIV disease factors, and demographic characteristics. RESULTS: A positive depressive phenotype prevalence was common among HIV-infected (prevalence = 33.1%) and HIV-uninfected MSM (prevalence = 23.2%). Compared to the depressive phenotype, trajectory models of CES-D>/=20 provided highest specificities among HIV-infected (specificity = 99.9%, 95% Confidence Interval [CI]:99.4%-100.0%) and HIV-uninfected MSM (specificity = 99.0%, 95% CI:97.4%-99.7%). Highest sensitivities resulted from classifying baseline CES-D >/= 16 among HIV-infected MSM (sensitivity = 75.0%, 95% CI:67.3%-81.7%) and four consecutive CES-Ds >/= 16 among HIV-uninfected MSM (sensitivity = 81.0%, 95% CI:73.7%-87.0%). CONCLUSION: Choice of method should vary, depending on importance of false positive or negative rate for long-term depression in HIV-infected and HIV-uninfected MSM.

PMCID

PMC6085148